STUTTERING THERAPY
2
ndEdition
by Phillip J. Roberts
Table of Contents
Preface
3Part I - Theoretical Descriptions of Stuttering
Chapter 1 - The Stuttering Iceberg 6
Chapter 2 - Tightening the Wrong Muscles 11
Chapter 3 - Interactions between the Different Elements of the
Stuttering Iceberg 16
Chapter 4 - The Fluency Iceberg 22
Part II – Therapy for Adult and Teenaged
Stutterers
Foreword 30
First set of exercises - Valsalva control
Exercise 1 - Stutter on Purpose 36
Exercise 2 - Relax Your Rectum 40
Exercise 3 - Abdominal Breathing 43
Exercise 4 - Don’t Perform Valsalva Maneuve rs When Unnecessary 45 Exercise 5 - Change the Way Your Body Reacts to Stress 48 Exercise 6 - Change the Way You Perceive Words 50
Exercise 7 - Phonate! 51
Exercise 8 - Air Flow and Easy Onset 55
Exercise 9 - Voiced Speech 59
Exercise 10 - Demosthenes’ technique 62
Second Set of Exercises - Changing Your Behaviors, Perceptions and Feelings
Exercise 12 - Listen to Others 88
Exercise 13 - You Are not Alone 90
Exercise 14 - Recall Enjoyable Speaking Experiences 92
Exercise 15 - Acknowledge Your Stuttering 94
Exercise 16 - Behave Like a Non-stutterer 99
Exercise 17 - Mirror 101
Exercise 18 - Keeping Eye Contact 102
Exercise 19 - Move Your Body 106
Exercise 20 - Speak With Your Body 108
Exercise 21 - How to Interrupt People 111
Exercise 22 - Speak Up! 113
Exercise 23 - Sing! 116
Exercise 24 - Pause! 118
Exercise 25 - Show Your Feelings 120
Exercise 26 - Don’t Hold Back 122
Exercise 27 - Be a Leader 124
Exercise 28 - Unveil Your Hidden Intentions 126
Exercise 29 - Avoid Avoiding 128
Exercise 30 - Adopt a Positive Attitude 131
Conclusion 134
Part III – Therapy for Children
Chapter 1 – Your Child Stutters 137
Chapter 2 – Indirect Therapy 140
Chapter 3 – Direct Therapy 148
Bibliography 152
All rights reserved. No part of this publication may be reproduced, stored in a retrieval sys tem, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the written prior permission of the author.
Preface
You are a stutterer and your dearest wish is to become fluent. You have the feeling that stuttering is controlling your life and you would like to find a way to control stuttering. Maybe you already explored several therapies and none of them really worked.
This book should allow you to improve your fluency and eventually totally eliminate stuttering from your life. The process will take a long time: probably several months and maybe more than a year. You were probably dreaming of a therapy that would enable you to control stutterin g in just a few days and might be somewhat disappointed to read that it will take a longer period of time. You have to understand that you have been stuttering for several years or decades. Stuttering is a habit that is now deeply rooted inside you and changing this habit will inevitably take time.
The first part of this book will give you theoretical descriptions of stuttering. It will provide you with the basic understanding that you need in order to control stuttering. You will learn that stuttering is a complex phenomenon that is not limited to your speech system. The stuttering phenomenon also includes all kind of behaviors and these behaviors will have to be changed one by one if you want to be able to durably control stuttering.
The second part of this book is composed of 30 exercises aimed at controlling your stuttering. These exercises are divided in two sets. The first set directly addresses the speech process while the second set addresses the different behaviors associated with stuttering.
It is possible that you will achieve fluency before you complete all the exercises. If this happens, I recommend that you nevertheless keep on working your way through the remaining exercises. Achieving fluency is a daunting task but maintaining fluency is not easy either. After you achieved fluency, it is very likely that you will relapse sooner or later. The exercises
contained in this book will not only help you to become fluent, but they will also help you to maintain fluency.
Now a word of caution: stuttering is a complex phenomenon and no two stutterers are alike. This book should be of great help to most stutterers but I cannot guarantee it will work for everyone. There is a slim possibility that after reading this book and doing all the exercises, you won’t notice any improvement. If such is the case, don’t give up. You can consult a speech pathologist or search the Internet for additional help. If there is a will there is a way. If you really want to control stuttering, you will find a way to achieve that goal. It might take time, but with perseverance, you are bound to succeed, with or without the help of this book.
If your Child Stutters…
If your child stutters, you should first read Part I (Theoretical Descriptions of Stuttering). These pages will help you understand the stuttering phenomenon and provide you with an insight of the feelings and perceptions of a stutterer. It will then be easier for you to understand your child and help him/her improve fluency.
Part II (Therapy for Adult and Teenaged Stutterers) was not written with the young child in mind. This part is primarily intended for teenagers and adults. Older children can also benefit from these exercises under the guidance of an adult. Whatever the age of your child, I recommend that you read Part II as the information contained in these pages will help you gather a better understanding of stuttering.
Part III (Therapy for Children) was written specially for you. It provides valuable information about children and stuttering. Part III also explains what you can do to help your child eliminate stuttering and become a fluent speaker.
I wish you good luck in your endeavor. If you have any questions or comments, don’t hesitate to contact me through the contact page of http://www.stuttering.ch.
Part I
Theoretical Description of
Stuttering
Chapter 1
The Stuttering Iceberg
In the Dictionary
According to the dictionary, to stutter means to speak with a spasmodic hesitation, prolongation or repetition of sounds (American Heritage Dictionary).
Every stutterer will probably agree that this definition is too short as it only describes the visible part (or more adequately the audible part) of the stuttering phenomenon.
To the stutterer, stuttering indeed means a lot more than a mere repetition of sounds.
Stuttering is also that strange feeling you feel in your guts when you know you are likely to stutter.
Stuttering means frustration, shame, guilt and lowered self esteem. Stuttering means that you will buy an apple pie instead of a doughnut because you feel that “apple pie” is easier to say than “doughnut”. Or maybe you will buy two doughnuts instead of one because you feel that “two doughnuts” is easier to say than “one doughnut”. Then you will pretend to wonder why you are not hungry enough to eat both.
Stuttering means that you will find all kinds of good reason for not asking for a pay raise although you obviously deserve it.
Stuttering means that the other guy will date that beautiful girl simply because you were worried that you might stutter when inviting her for dinner.
Stuttering also means using all kinds of avoidance techniques like using starters (you know…., you see…., well…, Yes…, uhhh… ) or using another less appropriate words simply because it seems that it will be easier to say.
Stuttering means you have to hear people giving you stupid and useless advices such as “take it easy”, “breathe”, “speak slowly”.
The Stuttering Iceberg
Stuttering is like an iceberg (see figure on page 10): it has both a visible part and an unseen part. The visible part, that is the part of the iceberg that lies above the waterline, accounts for only 10% of the total mass. The remaining 90% lies below the waterline and cannot be seen from the surface.
The spasmodic hesitations, prolongations or repetitions of sounds represent the visible part of the “Stuttering Iceberg” and is only a small part of the phenomenon.
The hidden part of the stuttering iceberg includes the following:
1) The tightening of the muscles of the Valsalva mechanism: This will be described in detail in the following chapter.
2) Irregular breathing patterns :
Stutterers often have irregular breathing patterns and have difficulties synchronizing breathing with speech. They sometimes attempt to speak with very little air in their lungs, or they try to speak while in haling.
3) Negative emotions, feelings and perceptions such as shame, guilt,
frustration, embarrassment, lowered self esteem, lack of self confidence :
Stutterers often feel ashamed of their inability to speak fluently and they often feel worthless because of the difficulties they have to communicate with others. They feel guilty of not being able to achieve what they feel they would be able to achieve if they were fluent. They feel emba rrassed by their disfluencies and the impatience of their listeners.
4) Fear of particular speaking situation:
Most stutterers fear particular speaking situations such as using the telephone, ordering food in a restaurant, asking directions to a pedestrian etc… Stuttering is usually situation sensitive. It depends on the individual, but a stutterer typically stutters more when talking to an authority figure such as a policeman, his parents, the teacher or his boss. Stutterers usually don’t stutter at all when talking alone or talking to a pet as long as no human being is around. Stutterers often stutter less when talking to their spouse probably because a spouse is a bit like a second self.
5) Use of starters and fillers :
When a stutterer feels he is going to block on a word, he often inserts meaningless words such as: “you know”, “you see”, “well”, “yes”, “uh”… Everybody tends to use such meaningless and useless words but this tendency is much more frequent among stutterers. Stutterers usually feel these junk words will give them a running start that will enable them to rush through the block.
6) Avoidance techniques:
When a stutterer feels he is going to block on a specific word, he often uses another word with a similar meaning. Quite often this other word is less appropriate and this may reinforce the perception that he is unable to communicate effectively. Stutterers sometimes say something completely different from what they would like to say.
7) Holding back :
Another way to elude stuttering is to avoid speaking. You probably remember having to listen to a person babbling nonsense simply out of a fear of speaking. This is probably one of the most frustrating situations a stutterer has to endure.
8) Eye contact avoidance :
Stutterers tend to avoid keeping eye contact with their listeners. They probably do so because they can’t stand seeing the reaction of their listener when they stutter. This attitude makes it difficult to establish effective communication with others.
9) Tendency to stand still:
Stutterers may be so scared to stutter that they rarely use body language while they speak.
10) Speaking in a low voice :
Many stutterers speak in a low voice because they don’t want too many people to hear their disfluencies.
11) Resistance to change :
At a conscious level, most stutterers obviously wish they could become fluent. But resistance to change is inherent to the human nature. A stutterer knows that if he becomes fluent, he will be expected to speak more and socialize more and his unconscious mind might think he will not be able to handle that. The unconscious mind will therefore resist the change and sabotage any effort to become fluent.
You now start to gather the idea that stuttering is not simply a speech problem. It’s a problem that spans throughout your entire body and mind. Stuttering affects the person as a whole and includes all kinds of behaviors, emotions, feelings and perceptions.
A therapy that only focuses on your disfluencies is bound to fail. Only a holistic and comprehensive approach that will also address the behaviors, perceptions and emotions that go along with stuttering can be successful.
The next chapter will describe how the tightening of the muscles of the Valsalva mechanism interferes with speech. In chapter 3, we will see how the different elements of the Stuttering Iceberg interact and reinforce one another.
The Stuttering Iceberg
Repeated sounds, disfluencies
Tightening of the muscles of the Valsalva mechanism
Negative emotions, feelings and perceptions
Use of starters and fillers
Avoidance techniques
Holding back
Eye contact avoidance
Tendency to stand still Speaking in a low voice Irregular breathing patterns Fear of particular speaking situations Resistance to change
Chapter 2
Tightening the Wrong Muscles
In this chapter, we will see how the involuntary tightening of certain muscles interferes with speech and triggers stuttering. These muscles belong to what the scientific community calls the “Valsalva mechanism”. This phenomenon was extensively demonstrated by William D. Parry in his excellent book “Understanding & Controlling Stuttering, A Comprehensive New Approach Based on the Valsalva Hypothesis”.
This chapter will only give you a brief overview of the phenomenon. I will give you the key elements you need to understand in order to control your stuttering. If you want to have a more thorough understanding of the Valsalva mechanism and how it interacts with speech, I strongly recommend that you purchase William D. Parry’s book. You can buy the book on www.amazon.com.
The Valsalva Maneuver
What happens when you lift a heavy box? You start by inhaling, then you hold your breath, grab the box and tense your muscles in your arms in order to lift the box.
Did you ever wonder why you first inhale and hold your breath when you have to lift a heavy object? You do that in order to inflate your chest and abdomen to make them rigid enough to withstand the weight of the object.
To hold your breath you close your larynx. The larynx is located in the throat and has two roles: phonation during speech and effort closure when we perform a strenuous effort.
Holding your breath by closing the larynx is not enough to maintain the rigidity of your chest and abdomen. You also need to tighten your abdominal muscles. By doing so you squeeze your intestines and it would have some very unpleasant consequences (involuntary defecation) if you didn’t instinctively tighten your rectal muscles as well. Actually, when you intentionally defecate, you also hold your breath and tense your abdominal muscles but you relax your rectal muscles instead of tightening them up.
To summarize: when you lift a heavy box, you hold your breath and tighten several different muscles: the muscles of your larynx, chest, abdomen and rectum. When you simultaneously tighten all these muscles, you perform a Valsalva maneuver. All these muscles are used to working together. If you tighten your rectal muscles you will notice that the muscles of your abdomen, chest and larynx also tighten.
Try contract ing your abdominal muscles. Wha t happens? Your larynx and your rectum also become tight. Similarly, if you close your larynx, the muscles of your abdomen and rectum will tighten.
To fully understand what happens during a Valsalva maneuver, do the following exercise: inhale, hold your breath and build air pressure in your lungs as if you were lifting a heavy box. Do this exercise moderately as it can be lethal if you have a heart condition.
Feel how the muscles of rectum, abdomen, chest and larynx are tight. Feel how your rectum and larynx are closed.
Notice how your lips are tightly closed. Your tongue and your jaw are also tight. In fact, your entire speech mechanism is numbed by the Valsalva maneuver.
Valsalva Maneuver and Stuttering
You might be wondering why I explained what is going on in your body when you lift a heavy box. The Valsalva maneuver is certainly an interesting topic but how does it relate to stuttering?
As explained earlier, the larynx has two basic functions: effort closure (when lifting a box) and phonation (speech).
During effort closure the larynx closes completely shut preventing the air from escaping from your lungs.
During phonation, the vocal cords of the larynx do not close completely and the air can gently escape from the lungs. The airflow causes the vocal cords to vibrate and hence to produce sound.
Stuttering occurs when the Valsalva maneuver interferes with phonation by triggering the closure of the larynx. The larynx shuts down completely and the air cannot flow out of the lungs. The vocal cords cannot vibrate and you are experiencing a stuttering block.
In some instances, you might be able to briefly relax the muscles of your larynx and a syllable or one or more words will burst out. Then you will block again as you perform another effort clo sure. Maybe you will repeat the same syllable each time you manage to briefly relax your larynx.
The Valsalva maneuver doesn’t only affect the larynx. When you perform a Valsalva maneuver the muscles of your rectum, abdomen, chest and larynx are not the only ones to tighten. The muscles of your lips and tongue will also become tight. Try to perform a Valsalva maneuver right now and notice the sensation in your lips and tongue. I am sure it will remind you of the feeling you have in your mouth when you stutter.
A Valsalva maneuver simultaneously affects speech in many different ways: it blocks airflow, it prevents the vocal cords from vibrating and it numbs the tongue and the lips.
Why do you perform a Valsalva maneuver during phonation? The reasons are not clear. Maybe you unconsciously think that words are hard objects that have to be forced out of your body and you perform a Valsalva maneuver a bit like when you want to evacuate your bowels or when you give birth. Maybe you think that speaking is difficult and should in volve strenuous physical efforts and you instinctively think that activating a Valsalva maneuver will help to expel the words out of your body.
Or maybe it’s due to the particular way the body of a stutterer reacts to stress. People react to stress in many different ways. Some people get a headache, others develop a stomach ulcer or lose their hair. A small minority react to stress by tightening the muscles of their Valsalva mechanism. Unsurprisingly, all stutterers belong to this small minority.
Whatever the reasons that pushes you to perform a Valsalva maneuver while you speak, it is important that you understand how it affects phonation and speech. Understanding the Valsalva mechanism is extremely important if you want to be able to control your stuttering.
Easy?
Maybe, you might start thinking: “It’s very easy to speak fluently: all I have to do is to avoid performing a Valsalva maneuver while I speak!”
Easy?
Next time you go to the bakery to buy a doughnut, don’t be surprised if you come back home with an apple pie! (You hate apple pies but it’s so much easier to say “apple pie” than to say “d-d-d-d-doughnut”…). You will indeed be very disappointed to realize that a mere intellectual understanding of the Valsalva maneuver and how it interferes with speech is not enough to control stuttering.
Any child has the impression that is easy to drive a car: all you have to do is press the accelerator to speed up, press the brake to slow down and turn the wheel to change direction. It’s seems very very easy. On his first day in driving school, a teenager suddenly realizes that it is not that easy and that he will probably have to drive a thousand miles before he feels somewhat at ease behind the wheel.
If you are used to driving a car with an automatic transmission and happen to rent a car with a manual transmission, you will obvious ly have a hard time getting used to shift ing gears. You will probably have to drive a few hundred miles before you feel really comfortable. In the meantime, you will inevitably stall your engine at every red light or stop sign.
Conversely, shifting from manual transmission to automatic transmission is not easy either. Your left foot will probably need several hundred miles before it understands it has to remain idle. In the meantime, it will search for the clutch each time you approach a red light.
Speaking is very much like driving a car: it involves many processes that are performed more or less unconsciously by our body. When you change direction you don’t consciously think of which muscles in your arms and hands you should tighten or relax to turn the wheel. You just decide where you want to go and your hands and arms do the job nearly automaticaly. Pressing the clutch and shifting gears is also done subconsciously and it’s very difficult to get rid of this habit the first time you drive an automatic car. Similarly, speech involves the subconscious tightening and relaxation of many muscles controlling inhalation and exhalation, the movement of your vocal cords, of your lips and tongue. If you stutter, it means that effort closure subconsciously interferes with this complicated process. Subconscious habits are difficult to change and it will take several months, maybe even a whole year, before you can become near ly totally fluent. Just
like it might take several hundreds miles before your left foot understands it has to stay idle the first time you drive an automatic car.
In the second part of this book, you will find exercises that will aim at relaxing your larynx and prevent Valsalva maneuvers from interfering with your speech. By practicing these exercises, you will gradually manage to control your stuttering and improve your fluency.
References
PARRY, William D., Understanding & Controlling Stuttering, A Comprehensive
New Approach Based on the Valsalva Hypothesis, National Stuttering Association,
1992
Chapter 3
Interactions between the Different Elements of
the Stuttering Iceberg
In chapter 1, we compared stuttering with an iceberg and suggested that the bulk o f the stuttering phenomenon is hidden below the surface. We will now look further into this concept and see how the different elements of the iceberg reinforce one another and work together toward one self destructive goal: stuttering.
Let’s have a look at each element of the iceberg and see ho w they interact with the other elements:
Tightening of the muscles of the Valsalva mechanism
You probably know what it feels like when the muscles of your Valsalva mechanism are tight. You rectum and abdomen are tight and this translates into a strange feeling in the guts. When the tightening is at its worse you also feel numbness in your lips and tongue. You have difficulties breathing in a normal way.
You know that if you speak, you are extremely likely to stutter. You will therefore tend to hold back and avoid speaking. If you do have to speak you will tend to use starters and fillers hoping that it will give you a running start. You will resort to avoidance techniques and use alternative words whenever you feel you are going to stutter on a specific word. You will speak in a low voice because you don’t feel at ease. You also tend to
avoid eye contact because you don’t want to witness your listener ’s reaction
if you happen to stutter. Because the muscles of your Valsalva mechanism are tight, you don’t feel relaxed and you prefer to stand still and avoid using
Irregular breathing patterns
If you speak without enough air in your lungs, you will speak in a low voice. You might also have a tendency to speak faster in order to be able to finish your sentence before you are out of air. Speaking faster is stressful and can induce the tightening of the muscles of your Valsalva mechanism. If you take a deep breath and then hold your breath before you start talking, you are also very likely to trigger a Valsalva maneuver.
Holding back
If you hold back and keep inside you what you want to say, you will be
frustrated by your inability to communicate. This frustration can induce a
tremendous amount of stress which in turn almost guarantees a tightening
of your Valsalva mechanism.
Fear of particular speaking situations
If you fear a particular speaking situation, you are very likely to hold back or if you speak, you will proactively resort to the use of starters and fillers or to avoidance techniques. You will also probably speak in a low voice and be too tense to use body language. Fear means stress and stress means
tightening of the Valsalva mechanism. Fear will also lower your self esteem.
Negative emotions, feelings and perceptions: shame, guilt, frustration, embarrassment, lowered self esteem, lack of self-confidence
If you are ashamed, feel guilty, frustrated, embarrassed, have a lowered self esteem and lack of self-confidence, you will speak in a low voice and will
avoid eye contact. If you don’t feel confident enough to claim your space,
you will have a tendency to stand still. If you lack confidence, you will avoid speaking situations and hold back. These negative emotions and perceptions are stressful and you will tend to tighten the muscles of your
Valsalva mechanism.
Use of starters and fillers
If you use starters and fillers, you might be able to successfully avoid stuttering. But you will be ashamed of the way you speak. You know perfectly well that it is not normal to use so many junk words. This will
inevitably lower your self-esteem. You use junk words to get a running start. Once you uttered the junk word, you will rush your speech hoping that stuttering won’t catch up with you. If you speak fast, you will get stressed and you will tighten the muscles of your Valsalva mechanism. Your mind is so busy with the starters and fillers that you don’t have time to use body
language.
Avoidance techniques
If you resort to avoidance techniques, it means you have to scan ahead for feared words while you speak. Each time you see a feared word looming ahead, you have to think hard of an alternative. All this background activity is exhausting and stressful and will inevitably induce the tightening of the
muscles of the Valsalva mechanism. You will have a tendency to
compromise your opinions or order food that you don’t really like to eat and this will induce negative emotions and feelings such as shame, frustration,
embarrassment, lack of confidence. You are so busy avoiding difficult
words, that you will probably forget about using body language.
Eye contact avoidance
If you don’t keep eye contact you will be out of touch with your listener. You will tend to feel embarrassed and not be at ease with the other person. This will generate stress and stutterers react to stress by tensing their
Valsalva mechanism.
Tendency to stand still and to avoid using body language
If you stand still you won’t be able to relax. You will tend to be more stressed and your Valsalva mechanism is more likely to tighten. If you don’t use body language, you will tend to stand still and this will increase your lack of self confidence.
Speaking in a low voice
If you speak in a low voice, this will translate as a lack of self-confidence. You will be less authoritative and assertive and people will be less likely to listen to you; you will feel embarrassed.
Resistance to change
If your unconscious mind resists change, you will deliberately tighten your
Valsalva mechanism and stutter. You will learn to live with your negative feelings, emotions and perceptions. You will consider the use of starters,
the tendency of holding back, avoidance of the use of body language, fear
of particular speaking situations, eye contact avoidance and avoidance techniques as normal facts of your life.
Repeated sounds and disfluencies
If you stutter, you will be stressed and you will tighten your Valsalva
mechanism. You will feel ashamed and embarrassed. You will be
frustrated by your inability to communicate. You will feel guilty of not being able to achieve goals that you believe would be achievable if you were fluent. You will lack self-confidence and have a lowered self-esteem. The stuttering blocks will block your airflow and will promote irregular
breathing patterns. You will resort to the use of starters and fillers hoping
that they will allow you to rush through difficult words. You will use
avoidance techniques to bypass feared words. Your fear of specific speaking situations and your tendency to hold back will be reinforced. You
will avoid eye contact because you don’t want to see your listener’s reaction to your stuttering. You will speak in a low voice because you don’t want too many persons to hear your stuttering. Your entire body will be numbed by the stuttering blocks and you will stand still unable to use body language . In some circumstances, stuttering will serve your interest; you can - usually unconsciously - use stuttering as an excuse to avoid answering an embarrassing question. This will reinforce your resistance to change.
The Intricacy of Stuttering
Now, have a look on the figure on the next page. It looks very messy… I simply drew a line between each elements of the stuttering iceberg that are related. If the line has two arrows, it means that the two elements are related by a two way relationship. Each element is at the same time the consequence and the cause of the other. If there is only one arrow, it means that it’s a one way relationship: one element is the cause and the other is the consequence; the arrow indicates the consequence.
This messy diagram clearly demonstrates the complexity of the stuttering phenomenon. Stuttering is not merely a fluency problem but a set of problems that reinforce one other. The only way to eradicate stuttering is to separately address each single problem. If you only address the
disfluencies, you might become temporally fluent but you are very likely to relapse a few weeks or months later because the other elements of the stuttering phenomenon will regenerate the disfluencies.
The same can be said for every other element of the Stuttering Iceberg. For example, you can use positive thinking to eradicate the negative emotions, feelings and perceptions related to stuttering. Within a few days, you will feel great. But the other elements are still there. You still react to stress by tightening your Valsalva mechanism, you still stutter, your speech remains jammed with junk words, you keep on ordering food you don’t really want to eat, you still avoid looking at people straight in the eye, you still have irregular breathing patterns, you keep on speaking in a low voice and your speech remains dull because you fail to use body language. Inevitably, your negative emotions, feelings and perception will resurface…
Stuttering is like a weed
Stuttering is like a weed. If you cut the weed, you will have the impression that you solved the problem: the weed is no t there any more and your garden looks neat. But cutting the weed only provides a temporary solution and the weed is likely to grow back within a few days or weeks. If you want to permanently solve the problem, you will have to dig out the roots of the weed.
In the next chapter, we will see in more details how we can dig out the roots of stuttering.
References
FRASER Malcom, Self -therapy for the stutter, Stuttering Foundation, 1978
HARRISON, John C., Conquer Your Fears of Speaking before People, National Stuttering Association, 1989
PARRY, William D., Understanding & Controlling Stuttering, A Comprehensive
New Approach Based on the Valsalva Hypothesis, National Stuttering Association,
The Intricacy of Stuttering
Repeated sounds, disfluencies
Tightening of the muscles of the Valsalva mechanism
Negative emotions, feelings and perceptions Use of starters and fillers Avoidance techniques Holding back Eye contact avoidance Tendency to stand
still Speaking in a low voice
Irregular breathing patterns
Fear of particular speaking situtations
Chapter 4
Fluency Iceberg
The Fluency Iceberg is very similar to the Stuttering Iceberg but is constructive rather than destructive. The tip of the Fluency Iceberg represents fluent speech. Below the waterline, you will also find 11 elements. Each element of the Fluency Iceberg is the counterpart of an element of the Stuttering Iceberg. All the elements of the Fluency Iceberg interact and reinforce one another and contribute to long lasting fluency.
You will find on the next page a figure showing the Fluency Iceberg. We will no w see how the different elements interact together.
Relaxation of the muscles of the Valsalva mechanism
During this therapy, you will learn to relax the muscles of your larynx as well as the other muscles of the Valsalva mechanism. You will also learn to react to stress by relaxing your Valsalva mechanism instead of tightening it. These techniques will contribute to enhance your fluency. Relaxing your Valsalva mechanism will also improve your breathing patterns. You will be more relaxed and it will therefore be easier for you to use body language. By relaxing your Valsalva mechanism, the feeling that stuttering blocks are imminent will ease and you will be more self-confident and outgoing. You will be less likely to use junk words or substitute words and it will be easier for you to look people straight in the eyes. If you are more relaxed, you will tend to be more assertive and speak with a higher volume.
The Fluency Iceberg
Fluent Speech
Relaxation of the muscles of the Valsalva mechanism Positive emotions, feelings and perceptions Speak without junk words
Saying what you mean without substituting words
Outgoing
Looking at people straight in the eyes Use of body language Speaking with a higher volume Breathing patterns synchronized with speech
At ease in any situation
Unconscious mind willing to change
Breathing patterns synchronized with speech
You will learn how to breathe in a relaxing way and how to synchronize breathing with your speech. This will have a direct effect on fluency and will contribute to the relaxation of your Valsalva mechanism. These improved breathing patterns will provide your lungs with enough air so that you can speak with a higher volume.
Positive emotions, feelings and perceptions
Some of the exercises of this therapy aim at changing the emotions, feelings and perceptions you have about your stuttering problem. You will learn to look at your problem more objectively and this will reduce or eradicate the feelings of shame, guilt, frustration and embarrassment. This will also prevent stuttering from undermining your esteem and your self-confidence. If you are not ashamed and embarrassed by your stuttering, it will be easier to look people straight in the eyes. If you are self-confident, you will be more outgoing, speak with a higher volume and use body
language. If you have positive emotions, feelings and perceptions, you will
be more at ease, more relaxed and therefore less likely to trigger a Valsalva
maneuver. Your mind won’t be plagued by confusion and this will improve
your fluency.
Speak without junk words
If you avoid using junk words, the grammatical structure of your speech will improve. You will feel better about yourself and you will be more assertive. This will enhance the positive emotions, feelings and perceptions you have about speech. You will not waste your airflow producing meaningless and useless words and it will be easier to synchronize breathing with speech and to speak with a higher volume.
At ease in any situation
As you go through this therapy, you will gradually reduce your fears of particular speaking situations. You won’t hold back anymore. If the fear is reduced, stress will be reduced as well and you will therefore be less likely to tighten your Valsalva mechanism. It will be easier to breathe smoothly. Being at ease, will enhance your positive emotions, feelings and
perceptions and it will be easier to look at people straight in the eyes and to use body language. You will be less likely to resort to the use of junk
words or to word substitution. If you are at ease in any situation, your
unconscious mind will have no valid reason to sabotage your efforts.
Outgoing
While you go through the exercises, you will be elated and energized each time you notice even a slight progress in your fluency. Being energized, you will be more talkative and outgoing and this will in turn have enhancing effects on the other elements of the Fluency Iceberg. Being more outgoing, you will be more at ease in any situation including the most difficult ones. You will feel great about yourself and your ability to communicate and this will enhance your positive emotions, feelings and perceptions. You will gain enough confidence to look at people straight in the eye and use body
language.
Saying what you mean without substituting words
If you don’t substitute, you don’t need to scan ahead for feared words and you don’t waste your brain resources finding alternatives. This will mean less stress and you will be less likely to trigger a Valsalva maneuver. You will say what you mean without compromising your opinion. You will eat the food you really want to eat. You will feel great about yourself and this will enhance the positive emotions, feelings and perceptions related to speech. You will be more assertive and it will be easier for you to look
straight into the eyes of your listener, to speak with a higher volume and to use body language.
Looking at people straight in the eye
If you keep eye contact, you will be in touch with your listener. It will be easier to use body language and you will feel more relaxed and hence be less likely to trigger a Valsalva maneuver. Communication with others will be more effective and this will enhance your positive emotions, feelings and
perceptions about speech. Speaking and interacting with others will be more
enjoyable and therefore less fearful.
Use of body language
Using body language renders communications more effective and lively. If you use body language, you will become more outgoing. You will be more assertive and therefore more self-confident. You will talk with a higher
volume and you will want to look at people straight in the eyes to see how
they react to your body language. Moving your body has a relaxing effect
on the Valsalva mechanism and will help you improve your breathing patterns. You will be more at ease even in difficult speaking situations. If
you are more at ease, you are less likely to use junk words or to resort to
avoidance techniques.
Speaking with a high volume
If you speak with a loud volume, you emphasize phonation and this has a relaxing effect on the vocal cords and improves fluency. You will be more assertive, people will be more likely to listen to you and this will improve your self-confidence. If people are more likely to listen to you, you will talk more and become more outgoing. You will probably want to further enhance your speech with body language. If you speak with a high volume, you will need more air and you will consequently breathe more regularly.
Unconscious mind willing to change
If your unconscious mind is willing to change, then it will make things a lot easier. You don’t have to worry about having your efforts sabotaged. You unconscious mind will have a positive effect on each and every element of the Fluency Iceberg.
Fluent speech
If your speech is fluent, your Valsalva mechanism will be more relaxed, you will have no reason to resort to the use of junk words or avoidance
techniques. You will be more at ease in any situation. You will be more
talkative and outgoing. It will be easier to look people straight in the eyes. You will speak with a higher volume because there won’t be any stuttering blocks to conceal. You will feel great about yourself and this will enhance the positive emotions, feelings and perceptions you have about speech.
The Intricacy of Fluency
Now have a look at the figure on the next page. It looks about as messy as the figure describing the intricacy of stuttering. But this time it’s a positive mess, it’s a mess that constructively promotes fluency. On the other hand, the figure describing the intricacy of stuttering is a negative mess; it’s a mess that negatively promotes stuttering.
Anyway, I think you now understand how this therapy works: you will address each and every element of the Stuttering Iceberg and replace it by its counterpart in the Fluency Iceberg. The elements of the Fluency Iceberg will reinforce one another over time and will all work together towards the development of fluency. You will create a self sustainable and stable system capable of main taining fluency for a lifetime.
The Intricacy of Fluency
Fluent Speech
Relaxation of the muscles of the Valsalva mechanism
Positive emotions, feelings and perceptions
Speak without junk words
Saying what you mean without substituting words
Outgoing
Looking at people straight in the eyes
Use of body language Speaking with a higher volume Breathing patterns synchronized with speech At ease in any situation Unconscio us mind willing to change
Part II
Therapy for Adult and
Teenaged Stutterers
Foreword
In Part I, I provided you with the basic understanding that you need in order to control your stuttering.
Understanding the stuttering phenomenon is an important step in the right direction but is not sufficient to achieve fluency. You now need to do some exercises in order to change the stuttering behaviors described in Part I.
These exercises are divided in two sets. The first set will aim at preventing the Valsalva mechanism from interfering with speech. These exercises are extremely important because they focus on the core element of the stuttering phenomenon. This first set of exercises alone is probably sufficient to yield significant improvements to your fluency after a few days, weeks or months of practice.
But this first set is not enough if you want to achieve durable and total control of stuttering. As we have seen in Part I, the stuttering phenomenon encompasses all kind s of peculiar behaviors related to stuttering. If these behaviors are left unchecked, stuttering will sooner or later fight back and you will again find yourself stranded on the Stuttering Iceberg.
For this reason, the first set of exercises is followed by a second set specifically aimed at changing your behaviors, feelings, perceptions and emotions. You will, among other things, learn to look people straight in the eyes, fight your hidden intentions, move your body, and change your perceptions about stuttering, about yourself and about others.
Thirty exercises are waiting for you and it will probably keep you busy for the next few months. Do not rush through the exercises. Take your time and do the exercises diligently. You probably wish you could become perfectly fluent within a few days but it is, unfortunately, not possible. You
will have to go through several months of hard work before your dream comes true.
If you wish you can start by quickly reading through all the exercises in order to gather an overall view of the therapy. You should then start over again and carefully read the exercises one by one. I recommend that you work on these exercises every day. Some exercises are fairly simple and all you will need to do is read it and think about it for 30 minutes or one hour. Then you can move on to the next exercise.
Other exercises are more difficult and will include techniques that you will have to practice during several days or weeks before you can fully master them. For exa mple, you might find that looking straight into the eyes of your listener is not easy and you might have to work on it for two weeks or more before it becomes second nature. Make sure you fully master an exercise before moving on to the next.
You should note that this book will teach you many different fluency enhancing techniques. As mentioned earlier, no two stutterers are alike and a particular technique that does wonders on one stutterer can be perfectly useless for another. Maybe you will find all the techniques useful or maybe you will find that one, two or more techniques are simply useless to you. If such is the case, feel free to skip them and spend more time and efforts on techniques that work for you. You should feel free to adapt the therapy outlined in this book to your particular case if you feel it’s necessary to do so.
As you go through the exercises you will feel that you are gradually getting a grip on your stuttering. Improvements will be slow but durable. Once you have gone through all thirty exercises, chances are you will still stutter although significantly less than before. I recommend that you go once again through the exercises and make sure that you incorporated all the techniques in your new way of life. Keep on working on your weak points. Make sure that your perceptions about stuttering as well as your behaviors are adequately altered.
Keep on doing the exercises until you become fully fluent. It might take a year or more but the benefits will last a lifetime.
Don’t try too hard
As explained before, stuttering occurs because the stutterer wrongly assumes that words need to be physically forced out of the body by using the Valsalva mechanism. While doing the exercises, you should be careful
not to trigger a Valsalva maneuver by trying too hard to be fluent. Keep in mind that the harder you try to be fluent, the more likely you are to stutter. Take it easy and remember that you will not become fluent overnight.
Relapse
You shouldn’t expect the road to fluency to be smooth. It’s more likely to be like a roller coaster ride with many ups and downs. It’s only after several successive ups and downs that fluency will become permanent.
Maybe you will become fluent in a few days or weeks from now and once you achieved fluency, you might believe that you will never ever stutter again. And then some time later, you will relapse and you will have the impression that the entire world is collapsing around you.
When a relapse occurs, don’t panic. Relapse is perfectly normal and should be expected. You were able to control stuttering prior to the relapse and you will soon be able to control it again. In the meantime, try to stutter freely and without shame and embarrassment. Calmly apply the techniques that previously helped you achieve fluency.
Don’t Tell Everybody that You Are not a Stutterer Anymore
When you become fluent, don’t tell everybody around you that you are not a stutterer anymore. If you do so, you will put yourself in a situation where you have to be fluent at all cost. You will have to try hard to remain fluent and the harder you try, the more likely you are to accidentally trigger a Valsalva maneuver and stutter.Forget that You are a Stutterer
As Wendell Johnson puts it: "Stuttering is what you do trying not to stutter again". In other words, you stutter because you are worried that you might stutter. The simple fact that you think about stuttering and recall past experiences of embarrassing stuttering blocks might tense your Valsalva mechanism and you will be very like ly to stutter again.
If you could forget that you are a stutterer as easily as I forget my wedding anniversaries, you would probably become fluent instantly. Unfortunately, it is very difficult to forget that you are a stutterer. The more you focus your mind on trying to forget stuttering, the more you will actually think about stuttering.
Instead of trying to abruptly chase stuttering out of your mind, you should turn the problem around and proceed in two steps: You first focus your mind on stuttering, you understand how it works and you learn how to control it. Then, once this is done, it will be easier to forget about stuttering.
Step 1: Focus your mind on stuttering
You first need to understand the stuttering phenomenon and fully understand how the elements of the stuttering iceberg interact with one another. Read again the preceding chapters if necessary.
You should then do the exercises contained in this book in order to enhance your fluency and replace each and every element of the stuttering iceberg by its counterpart in the fluency iceberg. By doing so, you will not only learn to control stuttering but you will also learn to eliminate the associated behaviors, perceptions and feelings. As you work your way through the exercises, you will reeducate your speech mechanism and you will gradually become more confident in your ability to speak fluently. You will behave and perceive verbal communication the same way a non-stutterer does. Your fear of stuttering and other negative feelings will slowly disappear.
Step 2: Forget that you are a stutterer
Once you are confident that you can control stuttering and its associated behaviors, perceptions and feelings, then you are ready to try to forget that you are a stutterer. Hide this book and other books about stuttering in a drawer; forget Phillip Roberts, your SLP, the fluency techniques you have learned, the web sites you have browsed and your past fears of speaking situations.
Pretend that you are a non-stutterer. Go out and speak naturally like you would if you had never stuttered in your whole life and see what happens.
If you fail, you can always step back, get this book out of the drawer, work again on the exercises and then try again later once you feel you are ready for the big jump.
Speak about stuttering with your partner
If you are married or share your life with another person, I strongly recommend that you speak with your partner about your stuttering problem. As you go through this therapy, your personality and behavior will change and your partner will have to adjust accordingly.
You will probably become more talkative and outgoing. You might want to socialize more and spend more time with your friends; and your partner might see that as a threat to your relationship. It will be easier for your partner to accept the changes if he or she knows why these changes are taking place.
Chances are that your partner is consciously or unconsciously protecting you by answering the phone or ordering food on your behalf when you go to the restaurant together. As you go through the exercises, you will probably want to be more in control of your life and you will not want your partner to do everything for you.
As you talk together about stuttering, maybe you will realize that your partner had no idea that stuttering had such a devastating effect on you. Maybe your partner perceives your stuttering as simply a funny way to speak and doesn’t understand why you should spend so much time and effort to solve this apparently meaningless problem.
After you have talked, your partner will probably be very curious to know more about stuttering and you can encourage him or her to read this book. You will then be able to talk together about the progress you are making and how the different exercises are helping you.
References
British Stammering Association: http://www.stammering.org/
HARRISON, John C., Conquer Your Fears of Speaking before People, National Stuttering Association, 1989
JOHNSON, Wendell, People in Quandaries, University of Minnesota Press, 1964 PARRY, William D., Understanding & Controlling Stuttering, A Comprehensive
New Approach Based on the Valsalva Hypothesis, National Stuttering Association,
1992
First set of exercises
Exercise 1
Stutter on Purpose
Why Stutter on Purpose?
Your aim is to become fluent and you will probably be reluctant to do an exercise in which you are asked to stutter on purpose. You should nevertheless do this exercise diligently as it offers several valuable benefits:
1) It will help you understand how Valsalva maneuvers can interfere with speech.
2) It will help you control the Valsalva mechanism and provide you with the practice you need to release a Valsalva maneuver when it occurs during an actual conversation.
3) It will help you reduce the fear you have of stuttering.
4) It will help you go straight through a stuttering block without resorting to avoidance techniques.
Perform a Valsalva maneuver
Inhale, hold your breath and perform a Valsalva maneuver as if you were lifting a heavy box. As mentioned before, a voluntary Valsalva maneuver should be done with moderation as it can be potentially lethal.
Feel the tension in your rectum, abdomen, chest and larynx. Notice how your rectum and larynx are tightly closed. Feel the tension in your jaw and tongue. Notice how your lips are tightly closed together. Become aware of
all the muscles that work together toward the same goal: making your body rigid so that you can lift the box.
Now, try to speak… Notice how it is simply impossible to speak while performing a Valsalva maneuver. Your entire speech mechanism is blocked: there is no airflow, you larynx is closed shut; your jaw and tongue are tight. Your lips are shut. Notice how it feels similar to what you feel when you are experiencing a stuttering block. Become fully aware that it is simply impossible to speak while a Valsalva maneuver is being performed.
Now relax the Valsalva maneuver. Feel how all the muscles that were involved in the maneuver are now relaxed.
Perform a Voluntary Valsalva Maneuver while You Speak
Put your lips together as if you were to pronounce a syllable starting with the letter p for example “pa”. Then, perform a Valsalva maneuver. Notice how yo ur lips are pressed together and how your larynx closes.Redo the same exercise, but this time, position your tongue as if you were to utter a syllable starting with t for example “ta”. Then, perform a Valsalva maneuver and notice how the tip of your tongue presses against your palate. Notice how it prevents the air from flowing out of your lungs.
Then, do the same exercise with the letter k. Feel how the middle of your tongue presses against your palate. There again, notice how it prevents the air from flowing out of your lungs.
Now, you will incorporate these exercises in full sentences and perform a Valsalva maneuver each time you encounter syllables starting by the following consonants:
p (except when followed by an h as it would then be pronounced like an f) t (except when followed by an h)
k
hard c (c pronounced like a k)
I suggest you read aloud written material such as this book and perform a Valsalva maneuver each time you come across one of the above consonants. Hold onto the Valsalva maneuver for a few seconds and the gently release the Valsalva maneuver before reading further. Make sure you gently release the pressure. Avoid explosive release of air from your lungs.
Keep on practicing with p, t, k and hard c until you fully master voluntarily Valsalva on these letters. Then add the other consonants to the list. Keep on practicing until you master voluntarily Valsalva on these consonants as well.
Call a Hotline and Stutter
I am sure you will want to skip this one.
Now that you practiced voluntary stuttering in the privacy of your home, you will practice while speaking with other people... I know it’s a very unpleasant exercise and the mere idea of stuttering on purpose in front of other people will make you want to run away. This exercise is very helpful as it will help desensitize you from the fear of stuttering.
Try practicing with relatives or friends. You can also practice this exercise when ordering food in a restaurant. If you feel uncomfortable doing so in a neighborhood where you know many people, take advantage of a trip to a distant city where nobody knows you. You can also call a telephone hotline such as the phone directory information or tourist information. Whatever your choice, make sure you stutter as badly as you can!
Relapse
In the previous chapter (Foreword) we mentioned the fact that relapses are very likely to occur several times during the course of the therapy. Voluntary stuttering is an excellent way to help you get ready to adequately manage relapses.
After you achieved fluency, I recommend that you once in while simulate a relapse by stuttering on purpose and then shift back to fluent speech. By deliberately alternating voluntary stuttering and controlled fluency, you will feel more in control and relapses will seem less frightening. You will be less likely to panic and you will know how to shift back to fluency.
References
PARRY, William D., Understanding & Controlling Stuttering, A Comprehensive
New Approach Based on the Valsalva Hypothesis, National Stuttering Association,
Stuttering Foundation: Counseling those who stutter, 1981 Stuttering Foundation: Transfer and maintenance, 1982
Exercise 2
Relax Your Rectum
As explained earlier, stuttering is due to the fact that we perform a Valsalva maneuver while we speak. During a Valsalva maneuver, the muscles of our larynx are tight and the air cannot flow. The vocal cords cannot phonate and we experience a stuttering block.
To prevent a Valsalva maneuver from occurring during speech, it can be very useful to relax the muscles of our larynx. Relaxing the muscles of the larynx is not easy. There are so many muscles involved that it’s difficult to relax all of them.
Why Should I Relax my Rectum?
The Valsalva maneuver involves a set of several muscles that are used to work together: muscles in your larynx, chest, abdomen and rectum. If you tighten one muscle, it will tighten the other muscles of the set. Conversely, if you relax one muscle, the others will tend to relax as well.
Instead of rela xing the muscles of your larynx, you will probably find that it is easier to relax your rectal muscle and to let the relaxation spontaneously spread all the way up to your throat. Yes this may seem very surprising but that’s the way it is: the easiest way to relax your larynx is to focus your attention on the relaxation of your rectum…
Jacobson’s Progressive Relaxation
I suggest that you use Jacobson’s progressive relaxation to relax your rectum. The basic idea behind Jacobson’s progressive relaxation technique is to first gradually tighten a muscle before gradually relaxing it.
Start by gradually tightening your rectal muscle. Notice the sensation of increased tension in your rectum. Keep on tightening your rectum until you reach maximum contraction.
Then gradually and slowly relax your rectal muscle. Notice the sensation of increasing relaxation in the area around your rectum. Once you attain maximum relaxation, start the process all over again. Gradually tighten your rectal muscle. If possible try to contract it a little bit more than the first time. Then gradually relax your rectum and try to relax it even more than the previous time.
Do this five or six time s. Notice how you rectum feels relaxed and open. Notice how this relaxation spreads all the way up to your abdomen, chest and larynx. Focus on your larynx and notice how it is relaxed and open. Notice how the relaxation spreads all the way to your jaw, mouth, lips and tongue.
Practice this Exercise all Day Long
Of all the exercises contained in this book, this exercise is probably one of the most efficient one. You can practice it anytime anywhere and you should practice it several times a day.
Before facing a difficult speaking situation, I suggest that you relax your rectum and make sure it remains relaxed while you speak. After you relaxed your rectum, focus your attention on the relaxation spreading through your abdomen, chest, all the way up to your throat and mouth.
Make sure your rectum is relaxed before you knock at the door of your boss. Relax your rectum while queuing up at the bakery or at the bank. Maybe you noticed from past experiences that the longer the queue, the more time you have to worry and the more likely you are to stutter. The situation will be reversed if you practice this relaxation technique: The longer the queue the more time you will have to focus your attention on the relaxation of your rectum and the less likely you will be to stutter.
References
PARRY, William D., Understanding & Controlling Stuttering, A Comprehensive
New Approach Based on the Valsalva Hypothesis, National Stuttering Association,
Exercise 3
Abdominal B reathing
Abdominal Breathing vs. Chest Breathing
There are basically two ways to breathe: either using the muscles of your chest or using the muscles of your abdomen. The most relaxing way to breathe is by using the muscles of your abdomen. This is called abdominal breathing. When you breathe abdominally, you abdomen moves back and forth. You can easily check if you breathe abdominally by lying on a bed and placing an object on your belly. If you breathe abdominally, you will see that object moving up and down.
Abdominal Breathing and Valsalva Control
Practicing abdominal breathing will help you relax the muscles involved in the Valsalva maneuver and at the same time supply your larynx with the airflow it needs to phonate.
You should first start by relaxing your rectum using the Jacobson’s progressive relaxation described in the previous exercise. Feel the relaxation spreading through the muscles of your abdomen, chest, larynx, tongue, lips and jaw.
Then inhale by slowly protruding your abdomen. Take a slightly deeper breath than usual. Don’t hold your breath; gently exhale by relaxing your abdominal muscles. You shouldn’t force the air out but rather let the air flow effortlessly through your open larynx. Breathing this way will help relax your Valsalva system and simultaneously supply your speech mechanism with the gentle airflow it needs. While you inhale and exhale
make sure your rectum remains open. Feel the relaxation of all the muscles of your Valsalva mechanism.
You can also practice this exercise almost anytime anywhere and you should practice it several times a day. You should practice it combined with the previous one (relaxation of your rectum) before confronting speaking situations that you perceive as potentially difficult.
References
KEHOE, Thomas David, Overcoming Stuttering in 6 months, A multifactoral Guide
To Speech Therapy, Casa Futura Technologies, 2002
PARRY, William D., Understanding & Controlling Stuttering, A Comprehensive
New Approach Based on the Valsalva Hypothesis, National Stuttering Association,
Exercise 4
Don’t Perform Valsalva Maneuvers When
Unnecessary
As explained before, we perform a Valsalva maneuver when we need to do some strenuous physical effort like lifting a heavy box.
In fact, we often also perform a Valsalva maneuver when it is not really needed; for example when opening a drawer or the door of the car. You might even do a Valsalva maneuver when picking up a paper clip on the floor. Of course, it’s usually not a full blown Valsalva maneuver. We simply slightly tighten the muscles of our Valsalva mechanism. But this is useless anyway.
I suggest that during the days to come, you pay attention to this strange phenomenon and that you deliberately avoid performing Valsalva maneuvers unless it is really necessary. The benefit of this exercise is that you will take the habit to control your use of Valsalva mane uvers and keep the muscles of your Valsalva mechanism relaxed at all times. This will in turn help you control your stuttering.
Driving a Car
Did you notice that you tend to stutter more when driving a car than when having a relaxing walk with a friend or comfortably sitting in a sofa?
I think the reason is that you tend to perform Valsalva maneuvers when pressing on the pedals and (if you have a manual car) when changing gears and this affects your speech.
